My diagnosis of COPD was confirmed with a breathing test called spirometry.

YesNoNot sure

Please select one of the options above first

I understand my COPD. My doctor or nurse has explained where to find information, advice and emotional support (if I need it).

YesNoNot sure

Please select one of the options above first

I get support to manage my care, and have agreed a written plan with my doctor or nurse about how I will manage my COPD.

YesNoNot sure

Please select one of the options above first

I contact my GP, nurse or pharmacist to get a free flu vaccination each year. I have also had the one-off pneumonia jab.You can get a flu vaccination from your GP, nurse or pharmacist from October.

YesNoNot sure

Please select one of the options above first

If I smoke, I am offered support and treatment to stop every time I meet my doctor or nurse about my COPD.

I don't smokeYesNoNot sure

Please select one of the options above first

I know the importance of keeping active and eating well.

YesNoNot sure

Please select one of the options above first

I have discussed pulmonary rehabilitation.

YesNoNot sure

Please select one of the options above first

I have received advice about ongoing exercise and nutrition.

YesNoNot sure

Please select one of the options above first

I know what all my medicines and inhalers are for and when to take them. I ask my doctor, nurse or pharmacist if I’m not sure.

YesNoNot sure

Please select one of the options above first

My health care professional reviews how I use my inhaler at least once a year. I ask my pharmacist if I have questions.

YesNoNot sure

Please select one of the options above first

I can spot the signs of a flare-up. This is sometimes called an exacerbation and can be the start of a chest infection.

YesNoNot sure

Please select one of the options above first

If I have a flare-up, I know who to contact at any time and what medicines to take. I have these medicines at home.

YesNoNot sure

Please select one of the options above first

I see my nurse or doctor at least once a year to review my health, my care and my treatment, and have time to discuss all the points mentioned previously.

YesNoNot sure

Please select one of the options above first

Great, we’re nearly done. You can personalise your passport by entering a bit more information. If you’d prefer, you can skip straight to your report. (If you are filling this out for someone else, please give their details)

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This will help us identify areas where we should campaign for better COPD care.

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Version 2. Last medically reviewed: June 2016. Due for review: June 2019